Like many women in high-density and peri-urban communities, Method Pagiwa (26), from Kuwadzana Phase in Harare, registered her pregnancy with the Antenatal Clinic at Rujeko Polyclinic in Dzivarasekwa, when she was seven months into her pregnancy. This, according to the World Health Organisation (WHO) standards is not recommended as they prescribe that women in developing countries such as Zimbabwe, should seek ANC within four months (17 Weeks) of pregnancy.
On July 7, 2023, Method started experiencing labor pains and her waters broke while she was on her way to the clinic. Upon arrival at Rujeko Clinic, and after the nurses had examined her, she was told that her baby had pooped in the womb and she needed hospital and specialist attention.
Within a short space of time, I saw an Ambulance arriving to ferry me to Perirenyatwa Hospital. In my head I was now wondering who had called the ambulance and how I was going to pay for the Ambulance fee as well as for the hospital and operation bills,” said Method.
Since Method was only two months into the Urban Voucher initiative being implemented by Cordaid and the Ministry of Health and Child Care through support from the World Bank (WB), she wasn’t very much aware of some of the perks and advantages that come with the program until the day of her delivery.
“I was admitted at Parirenyatwa Hospital and they conducted a scan which revealed that the baby had pooped in the womb two weeks ago. I was immediately booked for a Caesarean Section at Mbuya Nehanda Maternity ward here at Parirenyatwa. I was operated on and now I have this bouncing baby girl in my arms. All this I received for free curtsy of the Urban Voucher program.”
Thousands of women have benefited from the Urban Voucher (UV) system which is currently being implemented in two major cities of Harare and Bulawayo. The program works with social workers and rewards relief to the utilizers of the facilities, by paying on their behalf. The UV promotes institutional deliveries as well as providing free services on the other hand providing a cost recovery to the facility. It pays for user fees and is for urban settings. In Harare, Parirenyatwa Group of Hospitals acts as a referral point for all cases that would have been referred by all local clinics under the RBF Voucher System in Harare. Mbuya Nehanda, the Maternity division of Parirenyatwa Hospitals enrolled under the Urban Voucher system in 2021 and they started receiving patients with vouchers around January 2022.
Method was referred from Ruveneko Clinic in Dzivarasekwa township.
Sister Bernadette Mandaza, the Senior Nursing Officer at Mbuya Nehanda Maternity Hospital said they have served 2,900 women since 2022 under the RBF Urban Voucher program.
She said the patients who are on the Urban Voucher are usually maternity cases and they offer services for complications such as breached deliveries and Cesarean Sections as well as complicated post-natal issues.
“These include post-partum hemorrhage from the clinic, we also have premature babies referred to Parirenyatwa, Mbuya Nehanda.”
Parirenyatwa Hospital has received subsidies from the Urban Voucher program and they have managed to buy some medicines, surgical sundries, and some equipment. They have also brought a refrigerator and a microwave to put foodstuffs and warm for their employees to motivate them. The RBF Urban Voucher initiative is part of the Health Sector Development Additional Financing V , which is Co-financed by the Government of Zimbabwe and the World Bank, with Cordaid as the project implementing entity working with the Ministry of Health and Child Care, as well as Harare and Bulawayo Cities.
Story and photo Credits: Michael Gwarisa: https://healthtimes.co.zw/2023/07/28/a-fruitful-marriage-urban-voucher-system-reduces-maternal-deaths-in-harares-central-hospitals-council-clinics/#:~:text=In%20Harare%2C%20one%20of%20the,of%20care%20at%20the%20facility.